Clinical significance of branched Chain amino acid infusion during the treatments of patients with fulminant hepatitis

• Published in: Kanzo Vol. 20; no. 7; pp. 702 - 713
• Main Authors: HIGASHI, Toshihiro, OBATA, Takahiro, NAGASHIMA, Hideo, WATANABE, Akiharu, HAYASHI, Shosaku
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Hepatology 25.07.1979
• ISSN: 0451-4203; 1881-3593
• DOI: 10.2957/kanzo.20.702

Clinical significances of branched chain amino acid infusion to eight patients with fulminant hepatitis were investigated by infusing Hep-OU or Fischer solution containing 10-20% glucose for 18 days (average) during their treatments. Two cases with lower concentrations of branched chain amino acids in serum resulted in the complete awakening from hepatic encephalopathy within 2 days only by initiating the infusion of amino acids containing insulin-glucagon. The amino acid infusion with 1700 Cal/day, 31g of amino acids/day and 330 non-N Cal/g N for 37 days produced the awakening from encephalopathy and the improvement of abnormal EEG findings as well as the lowering levels of blood ammonia and elevations of serum BCAA/AAA in three cases. Hep-OU infusion is necessary in cases under direct hemoperfusion-hemodialysis for rapid improvement of their impaired serum aminograms. Four out of five patients received the amino acid infusion containing insulin-glucagon had the complete awakening from hepatic encephalopathy, but all these patients died within 42 days after the onset of the disease. Three cases with the very short duration times of the infusion, the very rapid progress of the disease and severe injury of central nervous systems did not have the apparent efficacy of the amino acid infusion.